Erbe e integratori, attenzione ai mix pericolosi

Erbe integratori attenzione mix pericolosi

Non tutti sanno che erbe e integratori alimentari possono non soltanto interagire con i farmaci, ma anche interferire con la loro azione. Spesso, infatti, si dà per scontato che le sostanze naturali, perché appunto “naturali” abbiano un effetto blando o non facciano male. Le cose non stanno esattamente in questo modo, in quanto farmaci e supplementi erboristici/integratori dietetici, ma anche gli alimenti, possono provocare effetti collaterali a causa delle interazioni fra i diversi principi attivi.

Alcuni, ad esempio, sanno che il pompelmo (idem per i preparati/integratori a base di pompelmo) interagisce con numerosi farmaci, tra cui: statine, calcio antagonisti e immunosoppressori. Ma non si tratta di un caso isolato ed è per questo che, prima di assumere qualsiasi farmaco o/e prodotto naturale (tisane, integratori alimentari, ecc.) è sempre preferibile consultare le indicazioni di Farmacovigilanza.

Il concetto non è di certo nuovo, tuttavia uno studio revisionale pubblicato sull’International Journal of Clinical Practice ne conferma ancora una volta la validità. Secondo l’indagine condotta dal team di ricercatori dell’Università di Farmacia di Taiwan, almeno metà dei pazienti con malattie croniche o tumori fa uso di rimedi naturali e integratori dietetici in combinazione con i medicinali prescritti. Le sostanze che più spesso provocano gravi problemi sono l’iperico (o erba di San Giovanni), il ginkgo biloba, il calcio e il ferro. Mentre echinacea, ioimbina e semi di lino sono i prodotti con la lista più lunga di possibili controindicazioni. Tra i farmaci, invece, l’acido acetilsalicilico, warfarina, insulina, ticlopidina e digossina fanno registrare il maggior numero di interazioni.

Come hanno spiegato gli autori dello studio revisionale:

Per lo più le interazioni provocano effetti negativi di intensità moderata; in 1 caso su 4 le conseguenze sono consistenti. In quasi la metà dei casi i problemi derivano dal fatto che erbe e supplementi alterano i processi di assorbimento, distribuzione ed eliminazione del farmaco prescritto. Per lo più le conseguenze sono disturbi gastrointestinali (16%), neurologici (14%) o genitourinari (12%).

Le prove sulle possibili interazioni e degli effetti collaterali che derivano dall’uso di erbe e farmaci sono sempre più numerose e sebbene le conoscenze in merito siano tutt’oggi incomplete alcuni dati sono noti ed è importante conoscerli.

Ad esempio, l’arancio amaro (citrus aurantium), utilizzato come supplemento nelle diete in quanto aiuta a bruciare i grassi, in combinazione con gli inibitori della MAO (farmaci antidepressivi), può causare l’insorgenza di una grave ipertensione. Per la verità, chi assume questi medicinali deve fare attenzione anche ai cibi che contengono tiramina e in particolare ai formaggi.

La bromelina, mix di enzimi estratti dalla pianta dell’ananas, viene spesso venduta come prodotto dietetico e anticellulite, ma per le sue proprietà anticoagulanti, quando somministrata in pazienti trattati con pentossifillina, può aumentare il rischio di eccessivo sanguinamento. Per gli stessi motivi, può essere pericolosa quando somministrata con eparina e warfarin (farmaci anticoagulanti). Inoltre, può aumentare l’assorbimento di tetracicline ed amoxicillina (antibiotici).

Anche gli effetti dell’echinacea non sono da sottovalutare, è in grado di inibire il metabolismo del midazolam (usato nel campo dell’anestesia) e della caffeina. Per effetto della sua attività farmacologica, l’echinacea può dare interazioni farmacocinetiche con farmaci che alterano il sistema immunitario. L’uso della pianta dovrebbe essere evitato in pazienti trattati con farmaci antineoplastici, inibitori della proteasi, inibitori nucleosidici e non nucleosidici della trascrittasi inversa, corticosteroidi o immunosoppressori.

Il ginkgo biloba, utilizzato contro l’invecchiamento precoce, ma anche per la cura dei disturbi della circolazione periferica come ritenzione idrica e cellulite, aumenta l’effetto di anticoagulanti, antiaggreganti piastrinici, antidepressivi, diltiazem e nifedipina. Riduce l’azione di antiepilettici, beta bloccanti e nicardipina. In associazione a fluoxetina e buspirone dà disturbi psichici e può indurre lo stato comatoso se abbinato ad alte dosi di trazodone.

Chiaramente, non sempre le interazioni di erbe e integratori fra loro o con i farmaci sono negative: a volte possono rivelarsi utili, se ad esempio un prodotto riduce la possibilità di effetti collaterali di un medicinale o ne rende possibile l’uso a un dosaggio inferiore.

Via| Farmacovigilanza; Photo Credit| Thinkstock

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92 commenti su “Erbe e integratori, attenzione ai mix pericolosi”

  1. Sono a dieta e sto prendendo le barrette herbalife che sono tutte naturali e mi sostituiscono un pasto. Ma non mi hanno mai detto che ci sono interferenze con altri prodotti, a parte i soliti mix di farmaci da evitare. Penso che l’importante sia sempre leggere le istruzioni per non correre rischi ed in caso di dubbi, chiedere al proprio medico di famiglia.

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